Increased levothyroxine dosage

[galactictiger]

Hello. I was diagnosed with hypothyroidism and anemia a little over a month ago. I'm taking iron for the anemia and 50 mcg levothyroxine. After about a week I began feeling some improvement in my energy levels, and hair loss was lessened a little, although still not optimal. This could be due to iron supplements or thyroid (most likely a combination.) About a week ago I started feeling really down again with fatigue, hair loss is increasing, irritated eyes, general puffiness all over, although exhaustion is not as severe as before meds. I was scheduled for a drs. appt. this morning and I thought the doc would re-check my thyroid to see how my levels were before adjusting my medicine, but she said she wanted to wait a couple more months to re-test. However she wanted to go ahead and increase my dose of levothyroxine to 75 mcg, based on how I'm feeling & how tired I look. I guess I do look kind of crappy with my tired eyes and flaky skin :(  
What I should look for in terms of receiving too much thyroid hormone? Jumping from 50 to 75 seems like a large increase, but she said that based on my weight (130lbs.) I could even have 90 mcg & that I should be fine. Is this usual?

[galactictiger]

I don't think they tested antibodies. Also, no ultrasound. I will ask about this when I go back. I also think I'll call to ask if I can try doing the 50 mcg/75 mcg alternating days like you did. I would be more comfortable doing that than just jumping up to 75 everyday. That's a terrific idea - Thank You!

[Barb135]

I would  much rather your doctor had retested prior to increasing your med, but it's apparent from your symptoms that you are still hypo, and I'd agree with  your doctor that your symptoms probably wouldn't improve much more without a dosage increase.  

Going from 50 to 75 mcg is a normal increase; however, as I said, it would have been better to retest first to see if you really need that much because you could get to 62.5 mcg by splitting a 25 mcg pill or alternating 50 and 75 mcg (50 one day, 75 the next to average out to 62.5).  I did that for quite a while with 75 and 88 mcg pills - worked beautifully till I needed another increase then I went to only 88.  

Both your FT4 and FT3 were relatively low in their ranges, so you will most likely do okay with the higher doses.  

Have you had antibodies tested?  That would be TPOab and TGab.  Also, have you had an ultra sound to check for swelling, inflammation or nodules?  If you have elevated antibodies and swollen thyroid, you would then be diagnosed with Hashimoto's Thyroiditis, which is an autoimmune disease in which the antibodies eventually destroy the thyroid.  For some, this process goes quickly; for others it drags on and on.  

Most hypothyroidism is a lifelong issue and it often takes many months/years to get everything leveled out so you feel "normal" again.  I've been working on mine for almost 3 yrs and am getting there, slowly but surely.  

[galactictiger]

Thanks for the responses:)  My initial labs were:
TSH 6.88
Free T4: 1.3 (range: 0.7-2.0)
Free T3: 2.7 (range: 2.3-4.2)

My doctor said that she wanted to wait to do the labs because I haven't been medicated long enough for it to have fully impacted my bloodwork, but that she didn't feel that my symptoms would improve much more on 50 mcg levo, so based on continuing hypo symptoms she upped it to 75 mcg. I just hope I continue to improve & don't go hyper.
Today my blood pressure & heart rate were more normal (110/60). For years it has been very low, sometimes freakishly so (88/46 is common for me).

[adviseneededplz]

to answer your greatest anxiety first,, levothyroxine can be prescribed to a dose of 150mcg in usual doses,, it is usually increased in doses of 25mcg at a time... secondly the medications are presribed on the basis of the type of hypothyroidism you are diagnosed with,, in some cases you need to cont the med for life time while in some you need it only for some week, and again for testing the actual thyroid function test you have to stop taking thyroxine for atleast 6 wks,, so i think seeing your general condition the doctor has proceeded to increase the dose of the medicine so as to titrate the symptoms,, which seems to be a perfectly natural course of action to be taken.. i hope i was helpful.

[blsdnsvd]

If you were started levo only 4 weeks ago, i'm wondering why the doc will increase the dosage when it takes up to 6 weeks to  regulate. Normally, labs are taken every 6weeks until the patient is leveled out but in your case, you just started. 75mcg's is not a big jump from 50mcg, that is actually the next dosage up.

If you post your lasted labs on this site, you will get better responses as far as where the numbers should be in order for you to feel better.

If I started my med's based on my weight, i'd probably have started off at 225mcgs and would've been very hyper.....instead was started on 50 mcg a year ago and am now at  100mcgs and that seems to be okay for me, although i still have very slight exhaustion but it's tolerable... In your case, your labs were probably not showing extreme hypo which is why you were started on a low dose.